Comprehensive abortion care service at Kathmandu Medical College--an experience.

INTRODUCTION His Majesty's Government amended the Nepal Criminal Code (Muluki Ain)--for Liberalising abortion law in the month of Chaitra 2058 (March 2002) and Royal Assent was given on 10th Asoj 2059 (27th September 2002). Accordingly Comprehensive Abortion Care (CAC) Services was initiated in the country. Kathmandu Medical College after enlisting with Ministry of Health started this service from June 2004. OBJECTIVE This study was carried out to know--1. Reasons for undergoing CAC service. 2. The complications after the CAC services. 3. The various contraceptive methods adopted by the client following CAC. METHODOLOGY Hospital based prospective study was carried out in Department of Obstetrics & Gynaecology at KMCTH from the period July 2004 to April 2005. Total 160 patients who asked for CAC were enrolled in the study. Counselling, history taking and general examination and per vaginal examination was carried out at the visit. CAC was performed with premedication with Doxycycline 100 mg and Ibuprofen 400 mg half an hour before the procedure. Paracervical block was also given with 1% xylocaine. MVA was performed as described in standard techniques. Patient was discharged after 1-2 hours of observation and with contraception opted by the clients. RESULTS Main reason for performing CAC was unwanted pregnancy in 66.75%. Complication following CAC was 1.25%. Post CAC contraception was adopted by 93%. Most preferred method was Inj. Depoprovera CONCLUSION The reason for CAC service asked by the patients was unwanted pregnancy. CAC service performed had minimal complication and also gave the opportunity for contraception.